Symptoms Of Metastatic Cancer
Metastatic cancer does not always cause symptoms. When symptoms do occur, what they are like and how often you have them will depend on the size and location of the metastatic tumors. Some common signs of metastatic cancer include:
- pain and fractures, when cancer has spread to the bone
- headache, seizures, or dizziness, when cancer has spread to the brain
- shortness of breath, when cancer has spread to the lung
- jaundice or swelling in the belly, when cancer has spread to the liver
Can Metastatic Breast Cancer Go Into Remission
Metastatic breast cancer may never go away completely. But treatment can control its spread. Cancer may even go into remission at some points. This means you have fewer signs and symptoms of cancer.
A treatment break may be considered in certain situations, including if remission occurs or if someone is experiencing intolerable side effects. A pause in treatment can help you feel your best and improve your quality of life.
Can Stage 4 Breast Cancer Go Into Remission
Stage 4 breast cancer can go into remission, meaning that it isnt detected in imaging or other tests. Pathological complete remission indicates a lack of cancer cells in tissues removed after surgery or biopsy.
But its rare to take tissue samples while treating stage 4 breast cancer. This could mean that although treatment has been effective, it hasnt completely destroyed the cancer.
Advances in stage 4 breast cancer treatments are helping to increase the length of remission.
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How Breast Cancer Spreads To The Lungs
Breast cancer starts in the breast. As the abnormal cells divide and multiply, they form a tumor. As the tumor grows, cancer cells can break away from the primary tumor and travel to distant organs or invade nearby tissue.
Cancer cells can enter the bloodstream or migrate to nearby lymph nodes under the arm or near the collarbone. Once in the blood or lymph systems, cancer cells can travel through your body and land in distant organs or tissue.
Once cancer cells reach the lungs, they can start to form one or more new tumors. Its possible for breast cancer to spread to multiple locations at the same time.
Life Expectancy Of Stage 4 Breast Cancer
Survival Rate With Metastatic Breast Cancer
Many people wonder about the life expectancy for stage 4 breast cancer . It’s important to note that everyone is different and survival rates vary widely. There are some people who survive many years and even decades with stage 4 disease. At the same time, it’s important to understand that stage 4 breast cancer isn’t curable.
It can be helpful to look at current statistics and consider the many variables that affect life expectancy. While it’s important not to raise false hope, it may help to know the reality that there are some long-term survivors.
Some people want to know the statistics, but many don’t. If you’re living with stage 4 breast cancer, there is absolutely no requirement that you know the prognosis. The information provided here is only for those who truly wish to know what the current research iseven this research has many limitations.
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How Is Metastatic Breast Cancer Treated
The main treatment for metastatic breast cancer is systemic therapy. These therapies treat the entire body. Systemic treatments may include a combination of:
Your care team will plan your treatment based on:
- Body parts cancer has reached.
- Past breast cancer treatments.
- Tumor biology, or how the cancer cells look and behave.
When Do People Get A Metastatic Breast Cancer Diagnosis
Metastatic breast cancer can occur at different points:
- De novo metastatic breast cancer: About 6% of women and 9% of men have metastatic breast cancer when theyre first diagnosed with breast cancer.
- Distant recurrence: Most commonly, metastatic breast cancer is diagnosed after the original breast cancer treatment. A recurrence refers to the cancer coming back and spreading to a different part of the body, which can happen even years after the original diagnosis and treatment.
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How Is Metastatic Breast Cancer Diagnosed
If you have symptoms of metastatic breast cancer, your provider may recommend tests including:
- Blood tests, including complete blood count and comprehensive metabolic panel.
- Imaging studies, including MRI, CT, bone scan and PET.
- Bronchoscopy, which uses a scope to look inside your lungs this can be done if there is a concerning spot in the lungs.
- Biopsy to remove tissue from a suspicious area and analyze it.
- A tap to remove fluid from an area with symptoms. For example, pleural tap removes fluid from the lung area. Spinal tap removes fluid from the spinal cord area.
When Can Metastatic Breast Cancer Occur
Most often, metastatic breast cancer arises months or years after a person has completed treatment for early or locally advanced breast cancer. This is sometimes called a distant recurrence.
Some people have metastatic breast cancer when they are first diagnosed . This is called de novo metastatic breast cancer.
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What Is Metastatic Breast Cancer
Metastatic breast cancer is the most advanced stage of breast cancer. Breast cancer develops when abnormal cells in the breast start to divide uncontrollably. A tumor is a mass or collection of these abnormal cells.
Metastasis refers to cancer cells that have spread to a new area of the body. In metastatic breast cancer, cells may spread to the:
Healthcare providers name cancer based on its primary origin. That means breast cancer that spreads to other body parts is still considered breast cancer. The cancer cells are still breast cancer cells. Your care team will use breast cancer therapies, even if the cancer cells are in other areas.
Survival Rates For Breast Cancer
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor, who is familiar with your situation, about how these numbers may apply to you.
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Prognosis And Survival For Breast Cancer
If you have breast cancer, you may have questions about your prognosis . A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors.
The doctor will look at certain aspects of the cancer or a characteristic of the person. These are called prognostic factors. The doctor will also look at predictive factors, which influence how a cancer will respond to a certain treatment.
Prognostic and predictive factors are often discussed together. They both play a part in deciding on a prognosis and a treatment plan just for you. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis and chances of survival.
Doctors use different prognostic and predictive factors for newly diagnosed and recurrent breast cancers. The following are prognostic and predictive factors for both.
Stage 4 Survival Rates
To get a perspective on the difference in survival rates during different stages of cancer, according to the American Cancer Society the rate of survival after diagnosis is:
- For those at stage 2 there is an expected five-year survival rate of over 90%.
- For those at stage 3 there is an expected five-year survival rate of 72%.
- For stage 4 there is an expected five-year survival rate of 22%.
Because the earlier stages of breast cancer have much longer survival rates, early detection and treatment are important.
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Symptoms Of Metastatic Breast Cancer
The symptoms of stage 4 breast cancer depend on the location of the cancer and where it has spread in your body.
- If breast cancer has spread to your bones, you may notice a sudden new bone pain. Breast cancer most commonly spreads to your ribs, spine, pelvis, or arm and leg bones.
- If it has spread to your brain, you may experience headaches, vision or speech changes, or memory problems.
- Breast cancer that has spread to your lungs or liver usually causes no symptoms.
The main treatments for stage 4 breast cancer are targeted drug therapies that destroy cancer cells wherever they are in your body.
These treatments may include:
- hormone therapy, which stops or slows the growth of tumors by preventing your body from producing hormones or interfering with the effect of hormones on breast cancer cells
- chemotherapy, where drugs given orally or through an IV travel through your bloodstream to fight cancer cells
- immunotherapy, which uses drugs that stimulate your immune system to destroy cancer cells
- a combination of these therapies
In some cases, surgery or radiation therapy may be used to treat stage 4 breast cancer.
The following are the common treatment options for different types of stage 4 breast cancer.
Symptoms Of Metastasis May Vary Depending On Where The Cancer Has Spread To
Here are some symptoms that vary by locations commonly associated with breast cancer metastasis.
Metastasis in the bone may cause:
- Severe, progressive pain
- Bones that are more easily fractured or broken
Metastasis to the brain may cause:
- Persistent, progressively worsening headache or pressure to the head
- Vision disturbances
- Behavioral changes or personality changes
Metastasis to the liver may cause:
- Abnormally high enzymes in the liver
- Abdominal pain, appetite loss, nausea, and vomiting
Metastasis to the lungs may cause:
- Chronic cough or inability to get a full breath
- Abnormal chest X-ray
- Other nonspecific systemic symptoms of metastatic breast cancer can include fatigue, weight loss, and poor appetite, but its important to remember these can also be caused by medication or depression.
If you notice these symptoms, be sure you talk with your physician. They could be important for getting the treatment you need.
Materials on this page courtesy of National Cancer Institute
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How Does Cancer Spread Or Metastasize
The spread of cancer usually happens through one or more of the following steps:
- Cancer cells invade nearby healthy cells. When the healthy cell is taken over, it too can replicate more abnormal cells.
- Cancer cells penetrate into the circulatory or lymph system. Cancer cells travel through the walls of nearby lymph vessels or blood vessels.
- Migration through circulation. Cancer cells are carried by the lymph system and the bloodstream to other parts of the body.
- Cancer cells lodge in capillaries. Cancer cells stop moving as they are lodged in capillaries at a distant location and divide and migrate into the surrounding tissue.
- New small tumors grow. Cancer cells form small tumors at the new location
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What Doesn’t Affect Survival
Just as there are factors associated with a better or worse prognosis, there are some factors that do not appear to make a big difference. These are generally less understood by the general public:
- Aggressiveness of treatment
- Having a positive attitude
The goal of treatment for metastatic breast cancer is often very different than that of early-stage disease, and this can raise anxiety among patients and loved ones of patients. With early-stage breast cancer, the goal is usually to be aggressive in order to reduce the risk that the cancer will come back.
In contrast, with stage 4 disease, the goal is usually to use the minimum amount of treatment possible to control the disease . Studies have found that more aggressive treatment does not improve survival rates but does reduce quality of life.
While having a good attitude may improve your sense of well-being, it has not been shown to affect survival rates. In fact, holding in negative emotions in order to appear positive may be detrimental to your health in general.
Stage The Stage Is The Main Prognostic Factor For Breast Cancer There Is Less Risk That Early Stage Breast Cancer Will Come Back So It Has A More Favourable Prognosis Breast Cancer Diagnosed At A Later Stage Has A Greater Risk Of Recurrence So It Has A Less Favourable Prognosis Doctors Will Consider If Cancer Has Spread To Lymph Nodes And The Size Of The Tumour When They Predict A Prognosis
If cancer has spread to lymph nodes
Whether or not cancer has spread to lymph nodes is the most important prognostic factor for breast cancer. Breast cancer that has spread to lymph nodes has a higher risk of coming back and a less favourable prognosis than breast cancer that has not spread to the lymph nodes.
The number of lymph nodes that contain cancer is also important. The more positive lymph nodes there are, the higher the risk that breast cancer will come back. Breast cancer that has spread to 4 or more lymph nodes has the highest risk for recurrence.
The size of the tumour
The size of the tumour is the 2nd most important prognostic factor for breast cancer. The tumour size will affect prognosis no matter how many lymph nodes have cancer in them.
Breast tumours that are 5 cm or larger are more likely to come back after treatment than smaller tumours. Breast tumours that are smaller than 1 cm and have not spread to the lymph nodes have a very favourable prognosis.
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Encouraging Statistics On Prognosis Of Metastatic Breast Cancer
In recent years, there have been some encouraging new statistics on the prognosis of metastatic breast cancer, these include:
- The statistics on survival rates show that women with breast cancer live longer today than ever before.
- In the past decade, the survival rate has substantially increased, due to an improvement in early diagnosis and screening, as well as improved targeted treatment.
- Survival rates are higher for women in higher economic groups
- The stage of cancer at the time of diagnosis plays an impactful role in prognosis, the highest survival rate begins for those who are five years post-treatment.
For Family And Friends
Caring for a loved one with stage 4 breast cancer has special challenges as well. Fortunately, organizations such as CancerCare now offer support groups design for loved ones who are caring for someone with cancer. In addition to caring for yourself , it’s helpful to learn about metastatic breast cancer.
Common things that people learn about cancer usually refer to an early-stage disease, and myths about metastatic breast cancer can be painful for those living with advanced disease. For example, one of the things not to say to someone with metastatic breast cancer is, “When will you be done with treatment?”
For the most part, people with metastatic breast cancer will require some type of treatment for the rest of their lives.
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How To Handle Emotions
Coping with the many symptoms that can occur with stage 4 breast cancer can be frustrating and discouraging, and people sometimes wonder if they will have to feel poorly the rest of their lives. Anxiety and depression are also severe for some people with advanced disease.
Fortunately, palliative care team consults are now offered at many cancer centers. While hospice is a form of palliative care, palliative care can be helpful even with early, curable tumors. Working with a palliative care team to address physical and emotional issues frees you up to work with your oncologist on issues that treat your cancer specifically.
While the research is also young, it appears that those people who receive palliative care consults not only have a better quality of life with advanced cancer, but they may actually live longer, too.
Why Does My Provider Need To Test The Metastatic Tumor
Your care team will test the metastases to figure out the biology of the tumor, which can help guide your treatment plan. Providers may test tumors for:
- Hormone receptor status: If the cancer is hormone receptor-positive, hormonal therapy may be your first treatment.
- HER2 status: Human epidermal growth factor receptor 2 is a protein that is overexpressed on some breast cancer cells. HER2-positive cancer responds to specific HER2-targeted therapies.
- PIK3CA gene mutation: If a tumor is hormone receptor-positive and HER2-negative, your provider may test for this gene mutation. Specific targeted therapies can be used to treat tumors with this mutation.
- PD-L1 status: Tumors that are hormone receptive-negative and HER2-negative may be tested for PD-L1 status. If the PD-L1 test is positive, you may be recommended to receive a combination of immunotherapy and chemotherapy.
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